Neeraj Jain
Sri Guru Ram Das University of Health Sciences And Research, India
Title: Stereotactic body radiotherapy in liver metastasis
Biography
Biography: Neeraj Jain
Abstract
Stereotactic Body Radiation Therapy (SBRT) also known as stereotactic ablative Radiotherapy (SABR) is a newer modality of delivering radiation therapy for many primary and secondary tumors, with good results. Liver metastases from colorectal, breast and lung cancer are most common. Studies focusing on SBRT for liver metastases from a single primary tumor type colorectal cancer have been published. Regardless of age, patients should have good performance status (Eastern Cooperative Oncology Group 0-1 or Karnofsky >70), with absent or stable extra hepatic disease and adequate hepatic volume and function. Number of metastasis should be less than three and size less than 6 cm. Prescribed dose
is generally very high in range of 30 to 60 Gy in three fractions. The toxicity profile is generally low with a G3 toxicity rate of 1-10% and the incidence of Radiation Induced Liver disease less than 1%. The most common G2 toxicities included a transient hepatic enzyme levels increase over three months of SBRT and gastrointestinal, soft-tissue and bone complications, related to lesions close to the duodenum, bowel, skin and ribs. Duodenal ulceration and intestinal perforation is observed in patients with maximum doses greater than 30 Gy in three fractions to the duodenum and bowel. In few patients, non-traumatic rib fractures were experienced for maximum doses of 51.8 Gy and 66.2 Gy in six fractions to 0.5 cm3 of rib. Local control rates varied from 70% to 100% at one year and 60% to 90% at two years and correlated to lesion size <3 cm.